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A bowel cancer trial using immunotherapy before surgery has shown zero relapses after nearly three years, offering hope for improved long-term survival
The study tested a short course of immunotherapy before surgery in people with a specific type of bowel cancer, with results suggesting a significant improvement over standard treatment.
Researchers from University College London say the findings could mark a major step forward in preventing the cancer from coming back, although further studies will be needed to confirm the benefits in larger groups.
Bowel cancer trial shows zero relapses after immunotherapy treatment
Bowel cancer is the fourth most common cancer, with around 44,000 cases per year. Nine in ten patients treated for stage one bowel cancer survive for five years or more; however, subtypes of tumours do not respond well to treatment and are more likely to return.
The NEOPRISM-CRC trial recruited 32 patients with stage two or three bowel cancer and a certain genetic profile (MMR-deficient/MSI-high bowel cancer) from five hospitals around the UK.
Patients were given up to nine weeks of pembrolizumab, an immunotherapy drug, before bowel surgery, instead of the usual treatment of surgery and chemotherapy.
The researchers found that initial results indicated that 59% of patients had no signs of disease after treatment with pembrolizumab and their planned bowel cancer operation.
Now, 33 months later, none of the treated patients has experienced a return of their cancer. This includes those who had no signs of cancer after treatment and those who still had small amounts remaining, which did not grow or spread during follow-up.
Experts hail bowel cancer trial results as “extremely encouraging”
Dr Kai-Keen Shiu, Chief Investigator of the trial from UCL Cancer Institute and a Consultant Medical Oncologist at UCLH, said: “Seeing that no patients have experienced a cancer recurrence after almost three years of follow-up is extremely encouraging and strengthens our confidence that pembrolizumab is a safe and highly effective treatment to improve outcomes in patients with high-risk bowel cancers.
“What is particularly exciting is that we now may be able to predict who will respond to the treatment using personalised blood tests and immune profiling. These tools could help us tailor our approach, identifying patients who are doing well and may need less therapy before and after surgery versus patients at higher risk of disease progression or relapse who need additional treatment.”
Professor Marnix Jansen, a clinician scientist and consultant histopathologist who is leading the translational research on the trial from UCL Cancer Institute and UCLH, said: “These results not only confirm the durability of responses we saw almost three years ago, but also provide crucial biological insights into why immunotherapy is so effective in this setting.”
Yanrong Jiang, first author of the latest abstract and clinical PhD student at the UCL Cancer Institute, said: “As a research team, we were thrilled to be able to follow patients very closely using the personalised blood tests. When tumour DNA disappeared from the blood, patients were much more likely to have no cancer remaining, and this matched the long-term results we’re now seeing.
“In addition, we also saw that immune profiling from tumour tissue, before patients start their first cycle of treatment, can help to predict response. We hope these tests may be used to guide treatment decisions in a more practical and timely way.”